Relevance and risk factors of enterococcal bacteremia following liver transplantation

Robin Patel, Andrew D. Badley, Jeffrey Larson-Keller, William S. Harmsen, Duane M. Ilstrup, Russell H. Wiesner, Jeffery L. Steers, Ruud A.F. Krom, Daniel Portela, Franklin R. Cockerill, Carlos V. Paya

Research output: Contribution to journalArticle

40 Scopus citations

Abstract

To analyze the clinical characteristics of and identify specific risk factors for enterococcal bacteremia following liver transplantation, we performed a study in 405 consecutive liver transplantation recipients prophylaxed with a selective bowel decontamination regimen. Seventy enterococcal bacteremias in 52 patients were identified. Enterococcus faecalis (50) outnumbered Enterococcus faecium isolates (18), and 49% of enterococcal bacteremias were polymicrobial. Biliary tree complications were present in 34% of enterococcal bacteremias. Of the 15 deaths (29%) among the patients with enterococcal bacteremia, 4 were directly associated with enterococcal bacteremia. In a multivariate analysis, Roux-en-Y choledochojejunostomy (P=0.005), a cytomegalovirus-seropositive donor (P=0.013), prolonged transplantation time (P=0.02), and biliary structuring (P=0.016) were identified as significant risk factors. Other risk factors identified in a univariate analysis included primary sclerosing cholangitis (P=0.009) and symptomatic cytomegalovirus infection (P=0.008). Enterococcal bacteremia is a frequent infectious complication in liver transplantation recipients receiving selective bowel decontamination. Its association with cytomegalovirus and biliary tree abnormalities suggest specific areas for prophylactic intervention.

Original languageEnglish (US)
Pages (from-to)1192-1197
Number of pages6
JournalTransplantation
Volume61
Issue number8
DOIs
StatePublished - Apr 27 1996

ASJC Scopus subject areas

  • Transplantation

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    Patel, R., Badley, A. D., Larson-Keller, J., Harmsen, W. S., Ilstrup, D. M., Wiesner, R. H., Steers, J. L., Krom, R. A. F., Portela, D., Cockerill, F. R., & Paya, C. V. (1996). Relevance and risk factors of enterococcal bacteremia following liver transplantation. Transplantation, 61(8), 1192-1197. https://doi.org/10.1097/00007890-199604270-00013